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Reproductive sequelae of parental severe illness before the pandemic: implications for the COVID-19 pandemic.

Abstract：

OBJECTIVE:To investigate, with pre-COVID-19 data, whether parental exposure to severe systemic infections near the time of conception is associated with pregnancy outcomes. DESIGN:Retrospective cohort study. SETTING:Population-based study covering births within the United States from 2009 to 2016. PARTICIPANTS:The IBM MarketScan Research database covers reimbursed health care claims data on inpatient and outpatient encounters that are privately insured through employment-sponsored health insurance. Our analytic sample included pregnancies to paired fathers and mothers. INTERVENTIONS(S):Parental preconception exposure (0-6 months before conception) to severe systemic infection (e.g., sepsis, hypotension, respiratory failure, critical care evaluation). MAIN OUTCOME MEASURE(S):Preterm birth (i.e., live birth before 37 weeks) and pregnancy loss. RESULT(S):A total of 999,866 pregnancies were recorded with 214,057 pregnancy losses (21.4%) and 51,759 preterm births (5.2%). Mothers receiving intensive care in the preconception period had increased risk of pregnancy loss, as did fathers. Mothers with preconception sepsis had higher risk of preterm birth and pregnancy loss, and paternal sepsis exposure was associated with an increased risk of pregnancy loss. Similar results were noted for hypotension. In addition, a dose response was observed for both mothers and fathers between preconception time in intensive care and the risk of preterm birth and pregnancy loss. CONCLUSION(S):In a pre-COVID-19 cohort, parental preconception severe systemic infection was associated with increased odds of preterm birth and pregnancy loss when conception was soon after the illness.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Kasman AM,Bhambhvani HP,Li S,Zhang CA,Stevenson DK,Shaw GM,Simard JF,Eisenberg ML

doi

10.1016/j.fertnstert.2020.09.153

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1242-1249

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(20)32395-5

journal_volume

114

pub_type

杂志文章

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